🔍💡 Women's health and precariousness: a ready-to-use workshop cycle to discuss periods, contraception, gender-based violence, and access to healthcare with those most affected. #Women'sHealth #HealthPromotion🧩🤝 From slums to detention: a practical guide to co-facilitating SAFE workshops, developing psychosocial skills, and reducing barriers to health rights. #SexualHealth #HealthEducation🔍➕ 📚📚 The guide directly addresses the needs of teams supporting migrant women living in slums, inadequate housing, or detention, with limited resources in sexual and reproductive health. It provides very concrete outlines for midwives, nurses, mediators, volunteer associations, or social professionals wishing to run workshops in small groups. It is immediately usable to structure a complete cycle or a few occasional sessions around periods, contraception, STIs, gender-based violence, and access to the healthcare system.
Source: 📒 SAFE: Intervening in Women's Health Collectively – A 'pick and mix' workshop guide for those concerned
📜🔗LIEN
Number of pages: 80 pages
1. Analytical summary
Context, audiences, and issues
The SAFE guide formalises a cycle of workshops that began in 2020 at the UGOMPS of the CHU of Nantes, initially aimed at sub-Saharan migrant women and then expanded to slums, inadequate housing, and women's detention. It is part of an approach to reduce social and territorial health inequalities by creating safe spaces for discussion on women's health in a broad sense (body, sexuality, maternity, violence, rights). The workshops have been stabilised and made sustainable following several general medicine theses, in partnership with the maternity unit, public health service, CeGIDD, PMI, Doctors of the World, Les Forges Médiation, and the CIDFF. The initiative particularly targets women with multiple vulnerability criteria: housing insecurity, fragile administrative status, language barriers, low health literacy, and experiences of violence. The central challenge is to strengthen psychosocial skills, self-esteem, and the ability to act, while concretely reducing barriers to access to care and rights.
Operational contributions for the field
The document proposes a clear methodological framework (principles of health promotion, roles, project stages, preparatory individual interview) followed by twelve fully scripted workshops with objectives, durations, materials, facilitation instructions, key messages, and debriefing time. The sessions cover anatomy and the cycle, menstrual hygiene, contraception, STIs, pregnancy, childbirth, HPV and smears, sexuality and pleasure, emotional relationships, gender-based violence, access to care, and unintended pregnancies. Each workshop incorporates proven facilitation techniques (photo language, positioning games, contraceptive colour chart, violence meter, card games on the health system) and ready-to-use appendices. The guide emphasises adaptability: the possibility to build a complete pathway or isolated workshops, mixed or single-gender facilitation, co-facilitation with participants, and adjustments to logistical and cultural constraints. It finally provides specific guidelines on the facilitation posture in intimate health, outreach, partnership work, and coordination with local resources, particularly in the Pays de la Loire.
2. Key points of the document
The SAFE cycle, a sustainable multi-partner initiative (p. 4–5)
The guide formalises a cycle of workshops resulting from extensive work with the CHU of Nantes, PMI, Médecins du Monde, Les Forges Médiation, and the CIDFF, supported by thesis work that justified its sustainability. It documents the genesis, the target audiences (migrant women, women in slums, in detention), and the logic of regular continuation of the workshops in 2025.
A methodological foundation in health promotion (p. 5–7)
The workshops are explicitly based on the principles of health promotion: a holistic approach, evidence-based data, participation of the people concerned, work on social and environmental determinants, and reduction of inequalities. The guide recalls the three pillars of health education (group dynamics, knowledge of the group, co-construction) and refers to recent methodological resources (Promotion Santé Ile-de-France 2024, Douiller 2020).
A very detailed and modular workshop architecture (p. 11–69)
Each session follows a standardised framework (welcome, ritual, central activities, closure, evaluation) with operational objectives, indicative timings, materials, step-by-step instructions, debriefing questions, and key messages to convey. This level of detail allows for implementation by diverse teams, including those with limited facilitation experience, and enables the composition of a 'tailor-made' course according to the group's needs.
Concrete and reproducible educational tools (Annexes, p. 77–80)
The annexes provide directly printable materials: photo language on rules, anatomy and cycle diagrams, contraceptive colour chart, practical tables/IST liquids, pregnancy tracking timelines, emotion cards, birth position cards, violence meter, health system game cards. The guide specifies the sources of these tools (AIDES, CRIPS, Ameli, France.tv, regional resources) and sometimes offers contextual adaptations.
A strong focus on access to care and the health system (p. 61–67)
The workshop "Access to Care" details the different coverages (Health Insurance, PUMa, Complementary Health Solidarity, AME), the associated rights, third-party payment, the role of the general practitioner, and emergency numbers. It offers a card game to explore care pathways according to coverage (consultations, emergencies, PASS, associations, sexual health centres) and clarifies alternatives to hospital emergencies for common symptoms.
3. Action points for local stakeholders
Structure a SAFE cycle adapted to your area (p. 5–7, 11–69)
Build a series of 6 to 12 workshops based on the SAFE framework, prioritising the themes identified with your audiences (e.g. menstrual hygiene, STIs, gender-based violence, access to care) and adjusting the duration according to your constraints. Systematically integrate an initial workshop for mutual acquaintance and a final in-depth closing session, as recommended in the guide.
Set up a preparatory individual interview (p. 8, annex 1)
Offer an individual interview lasting 20 to 60 minutes before entering the group to gather women's health history, needs, perceptions, and any situations of violence. Use the interview guide and visual aids (emojis, vignettes) provided in the annex to facilitate discussion on sensitive topics.
Equip teams for facilitating intimate health (p. 6–7)
Train or self-train facilitators in health education and intimate topics using the recommended resources (video Promotion Santé Grand Est 2022, Basics of Facilitation, EdSens booklet). Work upstream on representations, cultural biases, and role limits, systematically linking workshops with opportunities for referral to health professionals.
Co-facilitate with peers and strengthen partnerships (p. 4–5, 7–8)
Involve resource women from the group (community facilitators, former participants) in the preparation or co-facilitation of sessions, within the limits of co-preparation possibilities. Formalise links with PMI, CeGIDD, sexual health centres, local associations, and violence prevention initiatives to ensure concrete follow-ups after the workshops.
Develop a specific section on 'access to rights' (p. 61–67)
Systematically include the 'Access to Care' workshop in your SAFE pathways, adapting it to the services in your department (PASS, health centres, CAARUD/CSAPA, mental health associations). Use the game on health coverage and care pathways to identify major misunderstandings and, if necessary, co-construct a supplementary session on administrative procedures with social workers.
4. Additional References
🔍➕ Pour plus d'informations, voir les articles référencés par "Pratiques en Santé" sur le thème ➡️🔗
- on the theme of combating violence ➡️🔗https://pratiquesensante.odoo.com/2-2-lutte-contre-les-violences
- on the themepeople in migration situations -➡️🔗 https://pratiquesensante.odoo.com/5-7-personnes-migrants-demandeurs-assile
5. Cross-sectional analysis — values of Health Practices
Literacy: The guide significantly simplifies medical information (contraception, STIs, pregnancy, healthcare system) with diagrams, timelines, games, and key messages, but is designed for oral mediation rather than independent reading by low-literate individuals.
Empowerment: Participants are invited to share their experiences, co-organise and sometimes co-facilitate, to develop their own hygiene, contraception, or healthcare rules, which strengthens their individual and collective agency.
Participation: The workshops systematically integrate debates, photolanguage, positioning games, and co-construction of diagrams, within a framework that values each person's voice and experiential knowledge.
Community health: The approach targets groups living common realities (slums, detention, inadequate housing) and aims for collective changes (support networks, mutual aid, dissemination to the community), even if the grounding in formal community dynamics is not well detailed.
Ethics: The guide emphasises respect, confidentiality, the right to a joker, a total non-knowledge stance, and offers guidelines to question one's own representations, particularly regarding sexuality, violence, and motherhood.
Human rights: The approach is centred on equitable access to care, the right to information, to a chosen sexuality, to live free from violence, and highlights provisions such as PUMa, CSS, or AME for individuals in precarious situations or without papers.
Intersectorality: The workshops rely on partnerships between university hospitals, maternal and child health services, public health services, grassroots organisations, women's rights centres, and prison services, illustrating an action that intersects health, social, and legal fields.
Partnership: The document describes and values multi-stakeholder management, a steering committee, as well as cooperation between community facilitators, hospital professionals, and associations in the design and dissemination of the cycle.
Combating discrimination: The approach explicitly recognises vulnerabilities related to gender, migration status, housing conditions, and incarceration, and promotes a framework of non-judgment, openness to the diversity of experiences, and attention to gender-based violence.
The guide addresses several sensitive themes: sexist and sexual violence, sexuality, STIs, pregnancy, abortion, and unintended pregnancies, detention, extreme precarity, and migration situations.
Risks of emotional triggering:
Accounts of domestic, sexual, or institutional violence during the workshop "Facing Gender-Based Violence."
Traumatic memories related to pregnancy, childbirth, or perinatal loss.
Feelings of shame, guilt, or fear surrounding abortion, emergency contraception, or STIs.
Experiences of humiliation or lack of access to care in home countries or in France.
Cautions for facilitators:
Establish a very clear framework from the start: right to remain silent, right to leave, right to a joker, confidentiality among participants.
Provide possible individual time after the session for those in emotional difficulty, and referrals to specialised resources (violence, mental health).
Avoid staging or role-playing that could directly reactivate scenes of violence; prefer mediating tools such as the violence meter or situation cards.
Be attentive to signs of shock, withdrawal or agitation, and adjust the pace or content if necessary
6. Assessment of the reliability of the resource
Scientific relevance:
The guide is based on general medicine theses, recent regional and national resources (Promotion Santé Ile-de-France 2024, Ameli 2025, CRIPS, AIDES), and validated educational tools (contraceptive colour chart, violence meter, weak link of STIs).
The medical content (contraception, STIs, pregnancy, childbirth, healthcare system) is generally up to date with regard to the French recommendations 2024–2025, with a level of detail suitable for health education.
Operational relevance:
The document is very operational: timed scripts, material lists, question guidelines, examples of answers and key messages, ready-to-print materials.
It is designed to be adaptable to different contexts (outreach, fixed structures, detention) and to be used by non-specialist professionals or volunteers, provided that a partnership with healthcare providers is organised for situations that exceed the scope of facilitation.
7. MCQ — 5 questions
Part 1 — MCQ without answers
Question 1 (pp. 4–5):
The SAFE workshop cycle was initially developed:
a) In a family planning centre in a rural area
b) At the Medical Psycho-Social Obstetrics and Gynaecology Unit (UGOMPS) of the Nantes University Hospital
c) In a PMI in Loire-Atlantique
d) In a shelter for women victims of violence
Question 2 (pp. 5–7):
Among the guiding principles of the SAFE workshops, which one is part of health promotion as presented in the guide?
a) Aim solely at changing individual behaviours
b) Limit to standardised prevention messages
c) Act on multiple individual, social, and environmental factors
d) Exclude any consideration of social health inequalities
Question 3 (p. 21–24):
According to the contraception workshop, which method protects against both pregnancy and STIs?
a) The oestrogen-progestogen pill
b) The copper intrauterine device (IUD)
c) The internal or external condom
d) The contraceptive implant
Question 4 (p. 61–64):
The Universal Health Protection (PUMa) described in the "Access to Care" workshop:
a) Is reserved for people under 26 years old
b) Replaces the basic CMU and guarantees coverage of health costs for people working or residing in France in a stable and regular manner
c) Is only accessible to people who already have supplementary health insurance
d) Is solely intended for homeless individuals
Question 5 (p. 56, annex 15–16):
The violence meter used in the "Facing Gender Violence" workshop is primarily used to:
a) Measure the severity of physical injuries after an assault
b) Assess the frequency of disputes in the couple
c) Help identify signs of violence in an emotional relationship and identify dangerous situations
d) Rank couples according to their level of emotional compatibility
Part 2 — Commented correction
Question 1 (pp. 4–5):
✅ Correct answer: b) At the Medical Psycho-Social Obstetrics and Gynaecology Unit (UGOMPS) of the CHU de Nantes.
📝 Explanation: The guide specifies that the first workshops were set up in 2020 at the UGOMPS of the CHU de Nantes, for migrant women from sub-Saharan Africa, before being deployed in slums and detention. Source: pp. 4–5.
Question 2 (pp. 5–7):
✅ Correct answer: c) Act on several individual, social, and environmental factors.
📝 Explanation: The section "Basic Theoretical Principles" reminds us that health promotion projects, and therefore the SAFE workshops, aim to act on several individual, social, and environmental factors while reducing social and territorial health inequalities. Source: pp. 5–6.
Question 3 (p. 21–24):
✅ Correct answer: c) The internal or external condom.
📝 Explanation: The contraception workshop highlights that most methods (pill, IUD, implant) do not protect against STIs and that only internal or external condoms provide dual protection against pregnancy/STIs. Source: pp. 23–24.
Question 4 (p. 61–64):
✅ Correct answer: b) Replaces the basic CMU and guarantees coverage of health costs for people working or residing in France in a stable and regular manner.
📝 Explanation: The workshop "I explore the healthcare system" describes the PUMa as replacing the basic CMU and ensuring coverage of healthcare costs for anyone working or residing in France in a stable and regular manner. Source: p. 63–64.
Question 5 (p. 56, annex 15–16):
✅ Correct answer: c) Help to identify signs of violence in an emotional relationship and to recognise situations of danger.
📝 Explanation: The violence meter presented in the annexes classifies relational behaviours from green to red to visualise signs of respect, violence, and danger, and encourages seeking help when certain behaviours are present. Source: p. 56, annexes 15–16.
8. Frequently Asked Questions (FAQ)
Who can lead the SAFE workshops? (p. 7–8)
Anyone interested in women's health can lead these workshops, whether they are healthcare professionals, social workers, mediators, educators, or volunteers, provided they work on their posture and know their limits. The guide specifies that it is not necessary to know everything, but it is essential to refer to professionals for questions that go beyond the scope of the workshop. Source: p. 7–8.
How to choose the themes of workshops to propose to a group? (p. 5, 7)
The guide recommends starting from the needs expressed by the participants, through individual interviews or a collective gathering of expectations, and then creating a tailored programme from the 12 available sessions. It suggests systematically questioning the group at the end of each workshop to prioritise the following themes. Source: p. 5, 7.
Why is an individual interview recommended before group sessions? (p. 8, annex 1)
This interview provides a safe space to discuss women's health history, beliefs, violence, and specific needs, which is not always possible in a group. It also helps to build a trusting relationship and tailor the content of the workshops to the realities of the participants. Source: p. 8, annex 1.
How can we safely address the issue of gender-based violence? (p. 56, annexes 15–16)
The guide recommends scheduling the 'gender-based violence' workshop after the one on emotional relationships, so that the group has already built a climate of trust. It provides a violence meter and situation labels to work on the gradation of behaviours, identify warning signs, and direct towards specialised resources. Source: p. 56, annexes 15–16.
What are the main menstrual products discussed and how should they be presented? (p. 16–19)
The menstrual hygiene workshop invites the presentation of disposable and washable pads, tampons, menstrual pants, cups, and panty liners, listing advantages and disadvantages on a flip chart. It emphasises the frequency of changes, hand hygiene, and access to free products via the poster from the 'Basic Rules' website. Source: p. 16–19.
How does the guide help explain the French healthcare system to migrants? (p. 61–67)
A dedicated workshop details health insurance, PUMa, CSS, AME, the roles of the general practitioner, PASS, sexual health centres, and emergency numbers. A card game allows simulating care pathways according to health coverage and needs (pain, pregnancy, STIs, mental health). Source: p. 61–67.
Can men and non-binary people be included in SAFE workshops? (p. 4–7)
Yes, the guide specifies that workshops can be conducted in single-gender or mixed-gender formats, and that the participation of men and non-binary people is helpful for sharing contraceptive responsibilities, support, and communication within the couple. The choice of gender mix should be discussed with the individuals involved and adapted to the context. Source: p. 4–7.
9. Rewriting in Easy-to-Read Language
Title
SAFE: workshops on women's health.
Context and issues (Easy-to-Read Language)
This guide talks about women's health.
It is for very vulnerable groups of women.
For example: migrant women, women in slums, women in prison.
The workshops started in a hospital in Nantes.
The aim is to better understand one's body and health.
The aim is also to talk about violence and rights.
Operational contributions (Easy-to-Read Language)
The guide explains 12 workshops in detail.
Each workshop has simple objectives.
It includes the time, materials, and questions to ask.
There are games, cards, and images to use.
You can do all the workshops or just a few.
You can adapt to the needs of the group and the location.
Key points (Easy-to-Read Language)
The workshops are done with several partners.
They follow the rules of health promotion.
Participants talk a lot about their experiences.
There is a special workshop on access to care.
The guide emphasises respect and confidentiality